Kirsty Williams explains the Nurse Staffing (Wales) Bill.
In the next two weeks my new law to have safe nursing levels on Welsh hospital wards could become a reality as yesterday the Bill reached stage 3, and on February 10th will hopefully pass its final stage 4.
It is over 2 years since my name came out of the hat to make my own law through the private member’s bill process. I am delighted it has gotten this far. It is not an easy process to complete, of all the private member’s bill that there have been in the Welsh Assembly, only my Welsh Liberal Democrat colleague Peter Black’s bill to improve the rights of mobile home owners has made it to law.
The premise of the More Nurses Bill is very simple: nurses who have fewer patients to care for, can spend more time with each patient. As a result, they can provide better, safer care. The bill aims to ensure that nurses are deployed in the Welsh NHS in sufficient numbers to enable safe nursing care to patients at all times and to improve working conditions for nursing and other staff. This will lead to better care outcomes for those patients, and a more manageable workload which could help stem the flow of nurses leaving the profession.
As is always the case with these things, there have been changes and compromises along the way. The most noticeable change is the name. When we started this process the bill was called “Minimum Nurse Staffing Levels”, it quickly became apparent that people in the industry and patients preferred the term “Safe Nurse Staffing Levels” so the bill was changes to reflect that.
After that the health minister deemed that the word safe was not a suitable legal term, so yesterday we debated the “Nurse Staffing Levels (Wales) Bill”. I was reluctant to see the word safe go as I felt it made the bill stronger, but the legal advice I have had says that the change will make no material difference and will still achieve what I set out to achieve without the word safe. The name is secondary to the fact that this bill will save lives.
I have received a huge amount of support from organisations like the Royal College of Nursing (RCN) but I could not have gotten this far without the support of members of the public. Over 4,500 people have signed petitions in support of the bill and I am convinced that public support is what changed the Welsh Labour Government’s mind to support it.
A lot of water has flowed under the bridge in the Welsh NHS since December 2013 but I am just as convinced of the need for this piece of legislation now as I was then. Following the Mid Staffs scandal staffing levels guidance was issued to the England NHS bosses on safe staffing levels. In October last year, NHS bosses quietly told hospitals they no longer have to listen to that guidance in order to help tackle budget deficits.
This example is exactly why it needs to be written in law, so NHS bosses and governments of any colour cannot change their minds to quietly drop patient safety to make savings. Patient safety should always be a health service’s top priority, that is why I hope in a week’s time the National Assembly for Wales will be the first nation of the UK to enshrine patient safety in law in this way.
It is time for a good news story for our NHS, passing my More Nurses Bill would be that story.
Congratulations and thanks to Kirsty on a massive massive achievement! Once again Wales is leading the rest of the UK, and we should be very proud.
The changes of name during the passage of the bill should not make any difference – the content is what matters – but this should alert us to the need to keep a watchful eye on how the law is implemented. For example, although the numbers of qualified nurses are the core of the bill (research shows that when staffing numbers are such that a nurse is required to care for more than 7 patients the risk of mortality and complications increases), other things are important too. For example some managers might try to save money by substituting less qualified staff for qualified nurses – but the research shows that every substitution of a qualified nurse by a support work similarly increases the risks. Proper training (and the time to do it) are also very important, and the bill makes provision for this. We are already seeing how the (London) Department of Health is trying to slide out of things – for example by stopping the work that NICE was doing on the issue. I recommend that every patient admitted to a general ward (or their relative) should check daily the nurse patient ratio on their ward and complain if it is not better than 1 to 7. The ward nurses will thank you for it!¬